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PRE 2010 DOCSCity of Fridley, Mim. N® '7431. Date: Owner: Builder -- Address Address OF SUILQING No. Siareet '-lir, P of Lot Lot _ Block Addition or Sub -Division . Corner Lot Inside Lot _ . d/ Setback,e� _ _ _ Sideyard Sewer Elevation s f ( a -. -Elevation 7 a P or 19910-'x'A16 DESCRIPTION OF BUILDING T Used t �F tp r4 L Depth Height Sq. Ft. Cu. Ft Zz:z Depth eight - Sq. Ft Cu. FtTypeoY nsixuction - ._ ._ Est Cost ®To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set (girth and in compliance �� ns of ordinances of the city of Fridley. �� i� -/ In consideration of the payment of a fee of $ `� ,permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any pari thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buil within the dty ]units and this permit may be revoked at any time upon violation of any of the provisions of ordinances. NOTICE: This permh don not cover the comeruetton, hrshlldion for wbteg, phrmbing, gas hestteg, sewer or water. Be sure to we the Butldhig b qm ter for separde permhs for these hems. Of oew_ .r APPLICATION FOR BUILDING. PEHMXT CITYOF FRIDLEY, MINNESOTA. LOCATION OF 'BUILDING No. Street_Tart of Lot , Block Lot -Addition'or Subdivision Corner Lotide Ins LotZSetback :7aide-Yar/ SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to'this form .Two .Certificates of Survey of,Lot.and proposed build- ing location drawn on these Certificates., DESCRIPTION OF BUILDING To be used as: 7 6V 4%f ront 0!- 4 pth Height� Sq. Cu.. Ft.. FrontDepth L_Height — 95. Pt Cu. Ft.. Type of Construction Estimated Cost To be ComDleted / z" .The undersigned hereby'makes application on for a permit for the work herein specified, agreeing to do al ' 1 work in strict accordance with the City of Fridley Ordinances and rulings of the Department of,Butldings;, and hereby declares that all the facts -and representations stated in this application are true and correct; DATE X0 SIGNATURE 7-7 jSchedule of Fee Costs can be found on the, se Side). 4. Q 1. BUILDING PERMIT FEE SCHEDULE Section 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any exist- ing building or structure, or for any alterations or repairs to any existing .building or structure, upon application therefor, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the,manher herein provided to -wit: 2.1. For ant such permit for the erection of any fire -proof building, other than a garage' warehouse,, -factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the'rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For any such.permit for t`hib erection ofanyfire-proof garage, warehouse,_ factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section -502 -of the Minneapolis Building Code. a HOUSES 2.3. For any such permit for the erection of any non -fireproof building other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the,"tion of any non -fireproof garage, ,warehouse, factory or grain elevatoi^y, or for the erection of nny non -fireproof addition, for -similar occupancy, to any existing building or for each such building or addition - ninety cents'($0.90) for each one thousand cubic feet or fraction thereof, in.the cubical contents thereof with a minimum of $4,00.- For the purpose of computing fees for building permits, the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) incheo,below the floor line of.the -basement or cellar to the average height -4f -the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred Dollars ($500,00) or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fee-.charged..far_any-permit .as set forth in Section 2 be less.than $4.00. If suedEcr PERM City of Fridley ® 1801 AT THE TOP OF THE TWINS BUILDING PERM I T r CEIPT NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �6 1 � � "1 CITY HALL FRIDLEY 55432 �'"--AL, ,`� 7 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/28/85 JOB ADDRESS 7543 Tempo Terrace N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 4 Melody Manor 4th. Addition SHEET 2 PROPERTY OWNER MAILADDRES$ ZIP PHONE Clifford Carlson 7543 Tempo Terrace N.E. 786^3640 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW P ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK' Construct a 12' x 13" Parch Addition and a 101.x 10t Deck 9 CHANGE OF USE FROM TO STIPULATIONS porch.can not be heated unless porch.Alee.ts the energy code, �'ARNING PERMITS R�Q�,�RE® FOR SEPARATE pI= Before digging WIRING,' HEATING, PLUMBING AND SIGNS. call 10cal s ie TELEPW� L�C7RIC � utilitieGAs E REQUI.R,ED BY LA SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,800 $1, SO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $44.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $11.13 $57.53 SIGNAT F CO RACTOR UTHOR AGENT 'DATE) i WHEN PROPERLY �(,ALIDATED THIS IS YOUR PERMIT p 1 V D BLDG INSP DAT SiG A RE OF OWNER IF OWNER BUILDER' 'DATE) If NEW [ ] City of Fridley Effective 4/1/84 ADDN. I R-1 AND R-2 ALTER. [ ] Building Permit Application 7aa -re.`("i-aC� Construction Address: /7$y3 Legal Description: Lor 6, ®ILI Yl aCaAjSQa eMtoa� tlltel . # � r6 - 36MO C' ` I qo t d AJ Owner Name & Address : Contractor: cc.,fte- cto CL ba ve- Tel. # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT cw LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length `i Width �� Hgt/Ground Sq. Ft. M 1° OTHER: seg_D G.. / .qZ� �/��® �(�JV�/t Y,o� z 1�Z"7iaV1,7tr TX' 20 Corner Lot [ ] Inside Lot QC] Ft. Yd. Setbae Side Yard_Setbaek Type of Construction: Estimated Cost: $ o ® et Approx. Completion Date: - d C Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: V2 rr.- Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Hain Charge TOTAL STIPULATIONS: APPLICANT: a Tel.C-/e6-3 CITY USE ONLY .. $ 0 Fee Schedule on Reverse Side aM r7 $ 25% of Building Permit Fee $e® $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering $ $ o Agreement Necessary [ ] Not Necessary [ ] C&_"� """X L -D- 1_0_� ;j I�M" S--V� CAk BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection,of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: Total Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24"hours from the time 'of: application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. b, 3&T6� SUBJECT PERM City of Fridley M12 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV.PROTECTIVE 7ECEIPT�NO. INSPECTION SEC.® Jf CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'� 612-571-3450 910-F15 10/11/91 a/ JOB ADDRESS 7543 Tempo Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 4 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clifford Carlson 7543 Tempo Terrace NE 786-3640 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install two bay windows to Replace existing double hung windows 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan, a TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,800 $1.40 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ 54.00 Fire SC $2.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 58.20 SIGN&TURIE O ON T CTOROR THORIZ AGENT tDATEI WHEN PROPER Y A ED IS IS YOUR PERMIT S Y NSP "DATE SIGN U E OF O NER OWNER BUILDER) ID TEI OI MW [ ] Effective 1,/1/91 ADM [ ] I-1 AND R-2. ALTER M Replace \Ya\VS- Sai ding Permit Appiicatian Legal Description: owner Na®e Address: gel. A. # eet C/2�9/U contractor: DWetJ �2, Wl. # Address: Attach to this application, a certificate of Survey of the lot, with the proposed ams xuat.ion drawn an it to scale. IPIZON Cor 1I' LIVM AM: Length Width Height Sq. Ft. QRMM AIM: Length Width Height Sq. Ft. me= AM: Length Width Hgt/Gro:nd Sq. Ft. C2e-P I a C.e. corner Lot [ ] Inside Lot Zype of Cmwtruction: rear da4k- hu wir&ws-D Ft. d Setback Side Yard Setbacks Estimated Ms \.: $ 2. 6 00 - t!' AMrox. Cxupletion Date: 0 V. 19 CI Prcposed Driveway Width If New Opening Is Desired: Ft. $ $ ' Wath + 6' See Bark Page DATE: OC.T� 11% AMZC�+,I�Tr: Tel. # 7% - WO Permit Fee Fire surcharge State Surcharge SAC amarge Driveway Escrow Park Fee IL Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th $) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Be Determined byi Amement Necessary [ ] Not Necessary [] 2950 , (9005— eta /xJ S The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or struc um, q= application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the nwr er herein provided to -wit: $1 to $500 $15 (Minim Flee is $15 plus surcharge) $501 to $2,000 $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2, 000 $2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to arra including $25, 000 $25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1, 000 or fraction thereof, to and including $100, 000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1, 000 or fraction thereof, to and including $1, 000, 000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fracticn thereof Ddtt MMY BBPFMSIM =31011 (Concrete Curt Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet tames $13.50. Alternate "B": Removal and replacement of curb arra gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet timers $15.75. Permits for cons xuction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the cons:ructicn site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been cionsmucted will be requited before proceeding with the framing. :moi Y OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Effective On January 1, 2002 ' Fridley, MN 55432-: ..: APPLICATION FOR POWER PLANTS_AND HEATING, COOLING, VENTILATION, (763) 572-3604 _ _ REFRIGERATION AND AIR CONDITIONING SYSTEMS AND -DEVICES ' RATE SCHEDULE JOB ADDRESS_ OWNER Residential, Rate TOTAL Furnace Shell and NO Work, BurnerBUILDING (� USED AS Also Replacement F.' . ace $ 3Q.00 $ (Side Vent j Out Back) y ESTIMATED COST PERMIT NO. Gas Piping (Needed;wi-th�new furnace, $ 10.00 $ — but not replacement) Gas Range $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER Gas Dryer No..of Heating Units Circle One (Steam) (Hot Water)arm Air} $ 10.00 $ Trade Name b t� Size No._0(n® - BTUa ()Or—) L2� --.HPEDR Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs :& Alterations (LIST ON BACK) ., -." Burner Trade Name Size No. 1% of Value of Applicince or Work $ BfiUHP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ The.undersigned hereby makes application for a:permit for the work herein _ specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ :50..* rulings of the Building Division, and hereby declares that all the facts and :.: representations stated in this application are true and correct. _ TOTAL FEE DATE _ 9 cz_ MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO ` REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE 5.50.STATE SURCHARGE SignedTEL # SSC i FAX # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved BrRough-In Finpl Date1� 0"Z written permission from adjoining property owner. t THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VFNT. VFNT CC)NNF TQR ANN (Y)MRIISTICJN AIR V RIFT ATIC)N When replaringan axi t*ng fft_� nap, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-,GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) The existing_ combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new nambi istion air it will be sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When innsta„ (ling a new yLantingsv.4ftm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) Is the common vent and vent connectors sized and. installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Applian_ta JUpa and Si7P_/Common Vent and VA--nt Yes`Nf) No ( ) Informer Conn [`tor Appliance #1 Type BTU Input Fan AssistedrNa ion Appliance #2 Type BTU Input I Fan Assisted or�at Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height i ` Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: AIJ $igned By: Date G SUBJECT City of Fridley 33860 AT THE TOP OF THE TWINS BUILDING PERMIT t ` RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r I � E ' 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED 8Y j 763-571-3450 910-F15 9/8/03 10B ADDRESS 7543 Tempo Terrace NE 1 LEGAL LOT NO. TRACT OR ADDITION SEE ATTACHED DESCR. 6 JBLOCK 4 1 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clifford & Sheila Carlson 7543 Tempo Terrace NE 763-786-3640 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ( ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 24' x 14' Garage Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. SEPARATE PERMITS WARNING REQUIRED FOR: BOOM digging call t0T WIRING HEAPAI PLU all Utility lomi®ns 45 002 I AND $IG 9 BYLAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 I STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $7,428 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3.71 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $153.25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION Fire SC $7.43 PLAN CHECK FEE TOT FEE $ 64.39 S� NATURE F C RACTQR AUTHO �ZEO AGENT iD TE `/ ` C j�/►�,tetrt C9oe HE PROP L VALIDATE THIS I$ LOUR PERMIT J 8 G INSP DATE SIGN EOF OWNERJF OWNER BU4DER1 IDA Ei G NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571- 7 Fax �� BUILDING PERMIT APPLICATION. Construction Address: 7543 T F M P® -TER7 Legal Description: LQ -T io � 1-®�� `� R6 LZ 1) Y M A 00 Owner Name & Address: CLIFIFOiRD A. GAV,100 Tel. #'763 7S6— Contractor. C5U1.911)lafZ MN LICENSE # (� Address: Tel. # Attach to this application, a Certificate of Survey of the v � lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. t GARAGE AREA: Length 2-x-6 "®., Width /14—'Q" Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �—I 1 Construction Type: W 08 6> Fz Cid AtS Estimated Cost: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: occ Lo APPLICANT: . t �� '�'"` Tel. # 2d3 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ $ "� a $ X4011 TOTAL $ a _;�Cl CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUILDING PERNUT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $23.50 $501 to $2,000 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only Phone, CiRcenwooa 3-8352 C 0 Y* d A - ira rls on Jrr. ARLEIGH C. SMITH 7-5'43 TempO Terrace JA - 37 Registered Professional Engineer and Land Surveyor F), ;d y Al in r, 2030 East Wayzata. Boulevard Wayzata, MAnnesota PLAT OF SURVEY OF PROPERTY OF The- CO- -N described as follows: Q 7 6 BLOC K M, 10DX AfA&Qd -4th o6DD1T1QA1 Scale; 1 inchLeet, -TE MPC) TERRA L 7 D F A I /A 64 35-1171LIrY EASEMENT' CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY I hereby certify that on A U!q'e—'0' '19A5 I I hereby certify that on I made a survey of the awepave* location of the building surveyed the property described above and that the on the above described property and that, the location above .plat is a correct representation of said survey. of said building is correctly, shown on - t)00above plat A dr r -TE MPC) TERRA L 7 D F A I /A 64 35-1171LIrY EASEMENT' CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY I hereby certify that on A U!q'e—'0' '19A5 I I hereby certify that on I made a survey of the awepave* location of the building surveyed the property described above and that the on the above described property and that, the location above .plat is a correct representation of said survey. of said building is correctly, shown on - t)00above plat A dr ;ITY OF FRIDLEY INSPECTION DIV, 431 University Ave NE ridley, /IAN 55432 763) 572-3604. FAX (763) 571-1287 i Effective April 1. 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR -LUMBING FIXTURE RATES NO. RATE TOTAL lew Fixtures $10.00 )Id Opening, New Fixture $10.00 ;eer Dispenser $10.00 low Off Basin $10.00 -atch Basin $90.00 Win Water Leader $10.00 i ;umpJReceiaing Tank aa:z,.. s-�• s $35.00 sc i�E • • •��, tt �. r n�< t csiE • .i�� > � - :... v: u:. Vater Heater - Gas- 17,1 Sas Range" $10.00 35d: [r MR ^S2 tJ'v4T. ' .. _ty?osfF ON --rc_ a ��_WN, 1� m- • • . 1.40 al ME -LUMBING FIXTURE RATES NO. RATE TOTAL lew Fixtures $10.00 )Id Opening, New Fixture $10.00 ;eer Dispenser $10.00 low Off Basin $10.00 -atch Basin $90.00 Win Water Leader $10.00 i ;umpJReceiaing Tank $10.00 s Vater Treat" Appliance $35.00 LL +later Heater -Electric $35-00 Vater Heater - Gas- _ $35-00 Sas Range" $10.00 `-) ;as Dir-" $10.00 Sack Flow Preventer Required ( )Yes ( ) No Type $15.00 The undersigned hereby makes application for a permit for the work herein specified agreeing to do aU work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that aft the facts and representations stated in this application aretrueand22wrrrect. DATE: "� 1 �V 20 ® 9 - OWNER MI -DING USED AS & ESTIMATED COST PERMIT NO- ...... _ PLUMBING COIPANY A//pfZ9 2-ZW-l4 ieinspectkm Fee $50.00/Hr SIGNED BY TEL N0. Z - . VY sLL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fbcture Or Appliance Approved By Rough -In Date Final Date 9 State Surcharge $ .50 !, INlNINRIM FEE NY PLUMBINGIGAS PERMIT 15 $15.0Qor 6Y6 OF COST TOTAL FEE $ 1z OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $= n :OMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK ME